Simplified pulmonary embolism severity index is associated with recurrent venous thromboembolism in patients with pulmonary embolism

Pulmonary embolism(PE)patients have a high recurrence rate of venous thromboembolism(VTE)and recurrences are more often fatal.Recurrence can be effectively prevented by prolonged anticoagulation treatment,but the risk of bleeding also increases.Consequently,risk assessment of VTE recurrence is important in PE patients,as high-risk patients will benefit from long-term anticoagulation treatment,whereas low-risk patients will unnecessarily be exposed to an increased bleeding risk.Several risk factors for VTE recurrence have been identified in non-Asian populations,including male gender,advanced age,thrombophilia,obesity,persistent elevation of D-dimer one month after discontinuation of anticoagulation and residual thrombosis.However,risk factors for VTE recurrence have not been clearly evaluated in Chinese and Asian populations.A recent study found that the European Society of Cardiology(ESC)risk stratification for PE patients(2008 version),which is used to assess the disease severity of acute PE patients,was associated with VTE recurrence.[1]The simplified pulmonary embolism severity index(sPESI)is also widely validated for the assessment of disease severity of PE,has good prognostic value for early and even long-term mortality.It is less clear whether the model predicts VTE recurrence.The aim of this prospective study was to investigate the short-term and long-term incidence of recurrent VTE after a first episode of acute PE and associated risk factors of recurrent VTE.The association between VTE recurrence and disease severity assessed by sPESI was also evaluated.